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Type AB thymoma is not a mixed tumor of type A and type B thymomas, but a distinct type of thymoma

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Abstract

Type AB thymoma is generally regarded to be a mixture of type A and type B thymomas, but has not been studied extensively. In this study, we precisely investigated the characteristics of type AB thymoma immunohistochemically and compared it with other types of thymoma, including type A, metaplastic, and type B1 thymoma. In type A thymoma, the tumor cells were composed solely of pan-cytokeratin (CK-AE1/AE3)+ claudin-1+ vimentin− epithelial membrane antigen (EMA)− short spindle cells. Metaplastic thymoma exhibited biphasic architecture of epithelial islands of short spindle cells, which were phenotypically almost identical to the tumor cells in type A thymoma, and anastomosing bundles of CK-AE1/AE3− claudin-1− vimentin+ EMA+ fibroblast-like long spindle-shaped epithelial cells. Interestingly, we found that there were two distinctive subtypes of cell in type AB thymoma: the conventional subtype and the metaplastic subtype. The conventional subtype is characterized by type A-like components resembling type A thymoma. The metaplastic subtype is characterized by type A-like components extensively resembling the anastomosing bundles of fibroblast-like long spindle epithelial cells. Interestingly, the metaplastic subtype was a major subtype (14/19 cases), while the conventional subtype was a minor one (5/19 cases). In contrast to the rarity of metaplastic thymoma, the metaplastic subtype of type AB thymoma appears to be a major subtype of type AB thymoma.

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Abbreviations

WHO:

World Health Organization

Thymocytes:

Immature T lymphocytes

PBS:

Phosphate-buffered saline

CK-AE1/AE:

Pan-cytokeratin

EMA:

Epithelial membrane antigen

TCDM:

Thymic cortical dendritic macrophages

mmDC:

Mature medullary dendritic cells

EMT:

Epithelial–mesenchymal transition

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Acknowledgments

This work was supported in part by a Grant-in-Aid for Scientific Research (C) (2009–2012, No. 22590313) from the Ministry of Education, Culture, Sports, Science and Technology.

Conflict of interest

We declare that we have no conflicts of interest.

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Authors and Affiliations

  1. Department of Medical Technology, Kagawa Prefectural University of Health Science, Takamatsu, Kagawa, Japan

    Yukari Miki

  2. Department of Medical Technology, Graduate School of Health Science, Okayama University, Shikata-cho 2-5-1, Okayama, 700-8558, Japan

    Yukari Miki & Kiyoshi Takahashi

  3. Department of Pathology, Okayama University Hospital, Okayama, Japan

    Kana Hamada

  4. Department of Pathology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan

    Tadashi Yoshino

  5. Department of Pathology, Mitoyo General Hospital, Kan-onji, Kagawa, Japan

    Katsuya Miyatani

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  1. Yukari Miki
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  2. Kana Hamada
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  3. Tadashi Yoshino
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  4. Katsuya Miyatani
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  5. Kiyoshi Takahashi
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Correspondence to Kiyoshi Takahashi.

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Miki, Y., Hamada, K., Yoshino, T. et al. Type AB thymoma is not a mixed tumor of type A and type B thymomas, but a distinct type of thymoma. Virchows Arch 464, 725–734 (2014). https://doi.org/10.1007/s00428-014-1587-5

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  • DOI: https://doi.org/10.1007/s00428-014-1587-5

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